ArticleGastro hep advances2026
Nonlinear Association Between Metabolic Syndrome Severity and Advanced Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease.
Article in Gastro hep advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background and Aims: Metabolic dysfunction drives hepatic progression in metabolic dysfunction-associated steatotic liver disease (MASLD), yet conventional binary metabolic syndrome (MetS) definitions may obscure dose-response risk of fibrosis. We evaluated the association between MetS severity and advanced fibrosis probability in a representative US MASLD cohort. Methods: Adults aged 20-74 years with ultrasound-defined MASLD in the Third National Health and Nutrition Examination Survey were analyzed. Exposure was the validated MetS severity Z-score (quartiles, percentile categories, and continuous percentile with restricted cubic splines). Outcome was the Nonalcoholic Fatty Liver Disease Fibrosis Score (NFS)-defined advanced fibrosis probability (intermediate-to-high: NFS ≥ -1.455; high: NFS > 0.676). Complex survey logistic regression estimated adjusted odds ratios (aORs). Results: Among 3036 participants, 29.6% had intermediate fibrosis probability and 5.2% had high advanced fibrosis probability. High fibrosis probability was most prevalent in non-Hispanic Black adults (8.0%) and least in Mexican Americans (2.6%; Conclusion: MetS severity demonstrates a graded and nonlinear association with advanced fibrosis probability in MASLD. A continuous metabolic-burden measure may enhance upstream triage and risk stratification alongside existing noninvasive pathways.
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